Professor explains new national depression screening recommendations for adolescents

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The U.S. Preventive Services Task Force this week announced its new recommendation that all adolescents between the ages of 12 and 18 be screened for depression. The task force also urged doctors to ensure they have programs in place to help adolescents get treatment and follow-up if they are identified as having depression.

Alex Krist, M.D., an associate professor of family medicine and population health in the Virginia Commonwealth University School of Medicine, served on the U.S. Preventive Services Task Force that developed the national recommendations, and offered insight about their purpose and their importance to teenagers, their families and their educators.

Alex Krist, M.D.
Alex Krist, M.D.

What is the overall benefit of having systems in place to screen adolescents for depression?

Identifying depression is important, but the subsequent treatment and follow-up for adolescents who screen positive is what helps to improve how adolescents feel, their performance in school, family life and social functioning. It is essential for practices to have systems for diagnosis, treatment and follow-up of adolescents who screen positive for depression. That is why we included it in the core part of the recommendation.

What about a teen's genetic makeup, coupled with societal issues, make depression screenings necessary today?

Depression is common in teenagers. Many factors contribute to depression in teenagers – genetic, environmental and social. We don’t completely understand how they all interrelate and often there are different causes for different people.

Of what should parents/educators be cognizant when assessing whether a teen might be experiencing depression?

There are a number of signs and symptoms for depression. They can include feelings of sadness or hopelessness or worthlessness, irritability or anger, tearfulness or frequent crying, loss of interest in activities, changes in eating or sleeping, fatigue, difficulty concentrating, or thinking about death or suicide. With major depressive disorder these symptoms last more than two weeks, and they impair daily functions like school, work or family life. If parents are concerned that their teenager is suffering from depression, they should talk with their doctor. It is important to make the right diagnosis and make sure that the teen gets the right treatment.

What circumstances make a teen at risk for depression?

The resources, treatments and tools that each person needs are different.

Every person is different, but a combination of genetic, biologic and environmental factors can influence depression. For major depression in adolescents, having a personal or family history of depression, being overweight, having other mental health or substance use issues, or having a chronic illness may increase the risk. Studies that the task force reviewed also found that young women had a higher prevalence of major depressive disorder than young men. Psychosocial circumstances, like neglect, family conflict, traumatic events, loss of a loved one, uncertainty of sexual orientation, low socioeconomic status and poor academic performance, can also increase the risk of major depressive disorder.

What resources are available for adolescents struggling with depression, locally and nationally?

There are many resources locally and nationally to help with depression. I think one of the best ways to access these resources is to talk with your primary care doctor. The resources, treatments and tools that each person needs are different. Primary care doctors can specifically help you to find what you need.


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